Musical Training to Enhance Resilience of Underprivileged School-aged Children

The Chinese University of Hong Kong

Status: Enrolling

Conditions: Resilience; Depressive Symptom; Anxiety

Treatments: Behavioral: Active placebo intervention; Behavioral: Gamified music training

Study type: Interventional

Funder types: Other

Identifiers

NCT07165925

CRE-2024.498

Details and patient eligibility

About

This is a multi-centre randomised controlled trial aims to examine the effects of a group-based gamified instrumental musical training in enhancing resilience (primary outcome), reducing psychological distress (depressive symptoms and anxiety), enhancing self-esteem, and improving HRQoL (secondary outcomes) among underprivileged school-aged children at risk of mental health problems (depression and anxiety) during a 12-month follow-up.

Full description

Background: Child poverty is a prominent global health issue owing to its detrimental impact on a child's physical and psychosocial well-being. Nearly 356 million children lived in extreme poverty globally before the pandemic and this is estimated to worsen significantly. children growing up in poverty are more vulnerable to its effect and have an increased risk of psychosocial and developmental problems than children from affluent families. The impact of poverty is not only immediate during childhood but can persist into adulthood. Previous studies have shown that Chinese children from low-income families reported significantly higher levels of depressive symptoms, lower levels of self-esteem, quality of life, and life satisfaction than children from affluent families.

Therefore, there is an urgent need to design and implement promising and novel approaches for this vulnerable population to prevent children from developing mental health problems.

Growing evidence indicates the importance of fostering children's resilience to enable them to cope with adversity. Research found that resilience exerts a protective effect on the mental well-being of individuals facing adversity (i.e. exposure to poverty).

Emerging evidence reveals the promising effects of musical training of music-based interventions on enhancing resilience and psychosocial outcomes in paediatric populations. Yet, whether music-based interventions can enhance resilience in underprivileged school-aged children remains unclear.

If the proposed instrumental musical training programme is proven to be effective and sustainable, it can be recommended as usual care in the community care service for underprivileged children.

Hypothesis to be tested: Participants who receive the 6-month gamified instrumental musical training would report higher levels of resilience, reduced levels of psychological distress (depressive symptoms and anxiety), higher self-esteem, and better QoL than the placebo control group.

Design and subjects: A mulit-centre assessor-blind, randomised controlled trial will be conducted following the CONSORT guidelines; 174 underprivileged children aged 8 to 12 who are at risk of depression and/or anxiety will be randomised 1:1 to intervention or control groups.

Instruments: Validated questionnaires (RSES, CES-DC, SAS-C, RS10,and PedsQL 4.0).

Interventions: Weekly one-hour group-based gamified instrumental musical training session delivered by certified musicians for 6 months. The control group will receive weekly one-hour group-based indoor community leisure activities for 6 months.

Main outcome measures: Data collection will be conducted at baseline (T0), 6-month (T1;immediately post-intervention), 9-(T2), and 12-month(T3). The primary outcome is resilience level. Secondary outcomes include psychological distress (i.e., depressive symptoms and anxiety levels), self-esteem, and quality of life.

Enrollment: 174 estimated patients

Sex: All

Ages: 8 to 12 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Hong Kong Chinese children aged 8-12 years.
• Able to read Chinese and communicate in Cantonese/Mandarin.
• From low-income families.
• Have a risk of mental health problems, specifically depression and/or anxiety (determined through screening during the recruitment process using the Center for Epidemiological Studies Depression Scale for Children, with a cut-off score of ≥16 indicating a high risk of depression, and/or the State Anxiety Scale for Children, with scores between 36 and 60 indicating a significant level of anxiety)

Exclusion criteria

• Have chronic health conditions, cognitive and learning difficulties
• if they or their siblings are currently receiving or have received any music-based interventions before the study.

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

174 participants in 2 patient groups, including a placebo group

Gamified musical training

Experimental group

Description:

Participants in the gamified musical training group will receive weekly 1-hour lessons on a musical instrument for 6 months, delivered by professionally certified musicians. The intervention will be conducted in small groups (7-8 children/group). Two types of musical instruments (keyboard and ukulele) will be assigned to the participants based on their preferences.

Treatment:

Behavioral: Gamified music training

Active placebo control group

Placebo Comparator group

Description:

Participants in the active placebo control group will participate in weekly 1-hour group-based (7-8 children/group) indoor community leisure activities for 6 months.

Treatment:

Behavioral: Active placebo intervention